Supplement or snake oil?

IN THE INTERVIEW MONDAY in which President Bush made news by defending the teaching of the “intelligent design” theory, he also defended former Texas Ranger (now Baltimore Oriole) Rafael Palmeiro, recently suspended from Major League Baseball for a positive steroid test. “Palmeiro is a friend,” said Bush, once the Rangers’ managing partner. “He testified in public [that he never took steroids], and I believe him.”

That came as Palmeiro was suggesting he had ingested something in a “dietary supplement,” as bodybuilding powders are ridiculously called.

Given that the testing found an older-model steroid in Palmeiro, one not associated with supplements, that excuse had all but vanished by Tuesday. But the credence it received tells a lot about how little the supplement industry has to do with nutrition.

Most people take supplements expecting specific results, from bigger muscles to fewer head colds. The compounds come as powders, pills and drops, like drugs. Some have strong, dangerous interactions with both prescription and over-the-counter drugs (for instance, ginkgo, often bought as a memory aid, dangerously interferes with prescription blood thinners). They promise nothing, but hint at “health” for specific functions, such as the male prostate, the eye, the immune system or one’s mental outlook.

A good example is echinacea, long touted as a preventer or minimizer of the common cold. (Two ounces of the extract retails for about $20.) University of Virginia scientists conducted a broad and rigorously controlled study, the first ever, and found evidence that it does nothing. You get a cold, then you get well, with or without the herb and the $20.

A caveat at the end of the study, published this week, was eye-catching: “Given the great variety of [commercial] echinacea preparations, it will be difficult to provide conclusive evidence” regarding the herb. That “great variety” is a danger as well as an industry excuse. Consumers can rarely know for sure exactly what they’re getting.

The supplement industry, whose biggest home base is Utah and whose biggest protector is Sen. Orrin Hatch (R-Utah), grosses about $16 billion a year. Hatch has backed rules and legislation that nip scandalous excesses (the sometimes fatal stimulant ephedra, blatant steroid precursors, specific claims of benefit or cure) in exchange for leaving the industry nearly free from having to prove safety and efficacy. It is a profitable wink-wink arrangement.

For most consumers, it just means wasted money. For the gullible or desperate, it may mean substituting herbs for chemotherapy. For doctors, it means patients who don’t tell them what “supplements” they are taking. For young athletes, it means the winning edge comes in a jar, especially given that Gov. Arnold Schwarzenegger is a chief supplement booster (and until recently a paid booster).

“The burden of proof should lie with those who advocate this treatment,” says the last line of the echinacea report. Until Congress stands up and applies that idea to the whole industry, consumers can only pay their money and take their chances.